Pubdate: Fri, 14 Feb 2014
Source: Los Angeles Times (CA)
Copyright: 2014 Los Angeles Times
Author: Sam Quinones
Note: Times staff writer Sam Quinones is on leave writing a book 
about the epidemic of painkiller and heroin abuse in America.


Philip Seymour Hoffman's Death Opens a Door on an Epidemic of Drug Abuse.

The death of Philip Seymour Hoffman last week, apparently of a heroin 
overdose, says a lot about the epidemic of opiate abuse gripping the 
United States.

That epidemic, which I've spent the last year researching for a 
forthcoming book, is rooted in a 20-year revolution in medicine that 
has resulted in far wider prescribing of opiates. Narcotic 
painkillers are now prescribed for chronic back and knee pain, 
fibromyalgia, headaches, arthritis and other ailments. According to 
the Centers for Disease Control and Prevention, consumption of these 
opioids has risen 300% since 1999, making them the most prescribed 
class of medicines in America.

After Hoffman's death, reports surfaced that the actor, a onetime 
heroin addict, had been abusing prescription opiates, which 
ultimately led him back to heroin. That's a common path, in part 
because of economics.

On the street, opiate pain pills sell for $1 a milligram, according 
to police and addicts I've interviewed across the country. An addict 
can need 150 to 300 milligrams a day. A comparable high from heroin 
is a fifth to a tenth the price, which is part of the reason its use 
has almost doubled between 2010 and 2012, officials say.

Marketing is another big part of today's heroin story. Heroin is a 
commodity. To differentiate their product, dealers market 
aggressively, which has helped propel its spread.

I read that packets stamped with the Ace of Spades brand were found 
in Hoffman's apartment. In the classic East Coast heroin markets - 
New York City above all - dealers can't fully control the quality of 
their imported product. So they brand, which allows a trafficker to 
create buzz for a commodity that he'd have a harder time selling in 
an unmarked baggie.

Among the most prolific heroin traffickers in America today is a 
loose-knit entrepreneurial group I've been researching from the tiny 
county of Xalisco in the Mexican state of Nayarit, where opium 
poppies flourish. They market through customer service.

Police and rehab counselors say that many new addicts are 
middle-class white kids reluctant to venture to skid row or some 
menacing drug house to procure drugs. So the Xalisco Boys, as a 
Denver police narcotics officer has dubbed them, have dispatchers 
take calls and send drivers to meet addicts at suburban strip malls - 
delivering dope like pizza.

They give out free samples outside methadone clinics, customers tell 
me, and offer deals: one balloon of heroin for $20 or seven for $100, 
thus turning addicts into salesmen, hustling enough orders to get the 
price break. Some dealers even call their buyers later to make sure 
they're happy. If addicts get a bad (read: less potent) dose, they 
can complain to customer service and get a free replacement.

Try doing that on skid row.

Their customer-focused marketing has helped the Xalisco Boys expand 
to 20 states and fuel a surge in heroin in cities that include 
Indianapolis, Nashville, Charlotte, N.C., and Columbus, Ohio.

Hoffman was the second celebrity to have apparently overdosed on 
heroin recently; Cory Monteith, of the TV show "Glee," died in July. 
Each time, news shows have discovered the supposedly new surge in 
heroin, which is really about a decade old.

But that's the point: This epidemic has spread in part because it's quiet.

Most drug scourges come with public violence. As a crime reporter in 
Stockton in the early 1990s, I wrote about crack-related drive-by 
shootings, carjackings and gang feuds. But with this opiate epidemic, 
the private home, like the one where Hoffman died, has replaced the 
public crack house. It seems the drug has narcotized public outrage, 
along with millions of young Americans.

Keep in mind though: Since the rise of the American automobile, 
traffic fatalities have been our leading cause of accidental death - 
until now. More people now die of drug overdoses - about 38,000 a 
year, according to the latest numbers from the National Center for 
Health Statistics. The largest category of drugs represented within 
that number is prescription opioids (16,000 roughly), according to the CDC.

So in the last seven months, I'm guessing something like 10,000 
Americans who weren't famous died from overdoses of opiate 
painkillers or heroin.

Meanwhile, many parents' lives are mangled though their children 
remain alive. Their kids have shape-shifted into lying, thieving 
slaves to an unseen molecule, and these parents await calls that a 
daughter has been arrested for hooking or that a son overdosed in a 
McDonald's bathroom. These parents' pain is as searing as the chronic 
pain that doctors treat with opiate painkillers. No one talks much 
about it - not even the ashamed parents - until a celebrity dies.

That's changing. I've met parents who are organizing - from Simi 
Valley to Portsmouth, Ohio, - because crying in a bedroom, arms 
around a photo album, makes no sense to them. But they have day jobs, 
and powerful market forces are arrayed against them.

So here's hoping that Hoffman's death, which encapsulates much of 
this epidemic, will also rouse us to a thing that is deadlier and 
quieter than any drug plague we've seen before.
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MAP posted-by: Jay Bergstrom